MIKA SOUTHALL

FORT WORTH, TX
NPI1346874369
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: TX  115249)
Enumeration Date2020-02-28
Last Update Date2020-02-28
Business Address
MIKA SOUTHALL SLP
3840 HULEN ST
FORT WORTH, TX 76107-7277
Phone number: 817-335-3022
Mailing Address
MIKA SOUTHALL SLP
PO BOX 2603
FORT WORTH, TX 76113-2603
Phone number: 817-569-4786